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I thought I might add a little guinea pig experiment I did on myself that didn't turn out so good. My hope is to raise awareness of a seemingly bad combination to promote safer use of the two drugs in question. I really thought this was necessary after seeing lots of posts about people using kratom to combat depression. Considering this is something St. John's Wort is actually for, I figured some people might benefit from hearing about my experiment.

First off I have taken St. Johns Wort in the past for depression. It seemed to work okay for about 3 weeks before I stopped noticing any beneficial effects. Whilst cleaning the other day I noticed an old bottle of it lying around. Out of curiosity I thought I would look into it more, mostly in concern of why it might have stopped working for me. I then came across this on webMD:

Quote:

Medications for pain (Narcotic drugs) interacts with ST. JOHN'S WORT
The body breaks down some medications for pain to get rid of them. St. John's Wort might decrease how fast the body gets rid of some medications for pain. By decreasing how fast the body gets rid of some medications for pain, St. John's wort might increase the effects and side effects of some medications for pain.

Seeing this I thought to myself, hmm, maybe this could inhibit how quickly my body gets rid of Kratom, thus giving me a longer, more intense high. Thus the experiment is as follows (times reflect moment in which kratom was ingested):

T+0:00: A single dose of Red Vein Borneo (Bali) kratom is ingested. 5 grams where mixed with some juice and downed. I should note this is my usual dose of Bali kratom.

T+0:20: Initial effects of kratom are noticed. Elevated mood, warmness coming over body. Again these are normal effects for me when taking kratom.

T+0:30: Seems to be kicking in stronger. My head feels a little funny. Kind of like there is a simultaneous feeling of pressure and lack there of.

T+0:45: Feeling noted above starts to intensify. I start to think "Wow, this is going to be one hell of a trip, I am starting to feel really fucked up".

T+1:05: Feeling in head continues to intensify. Normally I would be peaking on kratom right now, but effects don't seem to be there, or are at least being masked by the now unpleasant feeling in my head.

T+1:30: Not feeling the kratom at all any more, just this insane, almost indescribable sensation in my head. Starting to get worried about a bad interaction. Starting to feel simultaneous feelings of cold and hot. Heart rate is faster than normal. Some mild dizziness is noted upon standing, although this isn't totally out of the norm for me (with or without kratom).

T+1:35: I am really worried as to whether or not this might be acute serotonin syndrome as I have never experienced it before and thus don't know how to expect if it is coming on or not. Go outside to have cigarette to calm me down.

T+1:45: Come back inside after cigarette, didn't seem to help. Considering that the worst might be happening and I ask my roommate to hang out with me just in case anything bad happened and I needed immediate medical attention.

T+2:30: Hadn't eaten in a while, decided that might help, so I begin making food. Still weird feeling in head, heart rate still above normal, don't have a sphygmomanometer around but I would be willing to bet that my blood pressure was much higher than normal. Feels like a mild panic attack. Not sure if some of these symptoms are related to the combination or merely psychosomatic due to the intensely uncomfortable feelings I am having (specifically in my head). I should also note that the last hour I have had a funny feeling in my stomach, I guess it isn't funny, but odd and uncomfortable, it is similar to the feeling I get associated with panic attacks.

T+2:50: Finished eating. It wasn't easy to eat as I was more concerned with my well being than how hungry I was. I also decide to take a low dose of xanax (.125 mgs), .25 mgs is where I start getting 'desired' effects I guess you could say/what I use for sleep. I decided to take the xanax as I thought it might help relax some of the symptoms that might be related to a panic attack.

T+3:00: Me and the roommate go on a walk to a friends house. It is very close and a car/cell phone would have been readily available in case of emergency.

T+3:30: Starting to feel a little bit better, or at least not as nervous about what was happening to me. Still feelings of agitation, uncomfortable cerebral feeling is still present, still minor stomach discomfort, and heart rate is still a bit high.

T+4:15: Starting to 'come down' so to speak. Symptoms seem to be easing up immensely, although still very present. Am feeling a bit more relaxed as I am believing I will not be going to the hospital today (I am not totally attributing this to the xanax, but rather that my kratom dose has peaked and I am starting to come down).

T+5:40: Almost back to baseline (hey that's my user name!). Still experiencing mild discomfort in my head, although the rest of the symptoms have seem to have subsided. The head feeling is really hard to describe throughout this trip, but now seems to just be some minor 'pressure' I guess for lack of better words. Roommate, friends, and myself decide to play some board games.

T+8:00: Headed back home for the night with roommate. Feeling much better now. All the symptoms seem to have fully subsided. Fully comfortable that I am no longer in danger of having to be admitted to the hospital. Me and roommate get home and pop in a movie. About half way in I fell asleep.

T+16:30: Woke up, tv still on, was tucked in, roomie is also asleep on the couch (she must have still been worried about me ) Feeling totally fine. Proceed to go on with day as normal. Make roommate breakfast as a thanks for being so concerned with me.

All-in-all this was a terrible experience. I am not sure exactly what was going on with me, or how that a normal dose of SJW interacted with kratom in such a way. Not sure how they would have caused serotonin syndrome, or if that was really what I was experiencing. It definitely had aspects of a panic attack, but I am sure that it wasn't one (at least not totally) as I initially felt as though the experience was going to be good, and I haven't had one in quite a while.

Hope this proves useful to anyone who might be combining these two substances. If anyone who has experienced serotonin syndrome can spread more light on this, as the effects I have read about could be common of a lot of things, that'd be great. Kratom hasn't been studied all that much, and there are so many different alkaloids present in it and we don't really know how each one: acts, is broken down, or if there are any interactions.

Just goes to show you that wedMD is no place to get your information on how to get epically high. Big big mistake on my part, and I am usually so careful...

Interesting report.
Personally i think you just gave yourself an anxiety attack worrying over some interaction between the two.
There is no chance of Serotonin Syndrome unless you were taking something else as well as Kratom does not affect Serotonin.

Taking new drugs, or new combinations for the first time is often more than enough to get someone anxious and to cause the effects you felt.

Johns wort also works like an SSRI, so unless you had been taking it for an extended amount of time i dont think it could have affected your Serotonin. One cap is not going to create any risk of SS.

I take Kratom in combination with St. John's Wort at least a few times a week, I actually find it to be super pleasant. Not much different than a normal Kratom high except I'll be happier and the whole experience feels a bit more dreamy.

Interesting report.
Personally i think you just gave yourself an anxiety attack worrying over some interaction between the two.
There is no chance of Serotonin Syndrome unless you were taking something else as well as Kratom does not affect Serotonin.

Taking new drugs, or new combinations for the first time is often more than enough to get someone anxious and to cause the effects you felt.

Johns wort also works like an SSRI, so unless you had been taking it for an extended amount of time i dont think it could have affected your Serotonin. One cap is not going to create any risk of SS.

It's possible that you had a weird reaction to it- causing some unusual sensations that then caused some anxiety. I've had this happen before with various substances. Kratom itself has given me some unusual sensations from time to time that don't always occur. If any anxiety pops up from this, I just do some self-therapy, telling myself that I am under the influence of something, and it is normal to have strange sensations while under the influence of said substance. The anxiety then usually goes away.

Here is a good thread on how SJW works - there is a link to a study done. After reading this, it seems that it is very doubtful that SJW could cause serotonin syndrome in any dose, or in any combination (though I still would not combine it with pharmas).

That's more what my guess to it was, at least some of the somatic symptoms were probably caused by anxiety related issues. Still, a strange reaction definitely occurred. Since SJW is a CYP3A4 inducer, could it be maybe that one of the active alkaloids (or a few) in the kratom were processed too quickly thus causing an abnormal sensation?

Also thanks for the link! I have never read much into it other than some people finding it just as effective as prescription anti-depressants.

Anything is possible. I have had some weird sensations when mixing kratom with other ethnobotanicals, such as kanna and rhodiola rosea. Nothing crazy, but just some strange physical sensations.

I agree, especially with kratom. There are so many active alkaloids in it and at such varying levels, its really hard to tell how you are going to respond to any combination. Even more so when you consider how little research there is about any of them.